BOSTON  February 22, 2002  Prostate cancer patients
often receive androgen-deprivation therapy to reduce their levels
of the hormone testosterone, but the side effects have not been
well studied. A Massachusetts General Hospital (MGH) study published
in the February issue of The Journal of Clinical Endocrinology
and Metabolism reveals that unwanted weight gain, particularly
increased fat body mass, is a common occurrence in these patients.

"Most patients and their physicians are not aware of these
important side effects," says lead author Matthew Smith, M.D.,
Ph.D., an MGH oncologist. "They assume that something else
is wrong when they start gaining weight." Smith explains that
treatments aimed at lowering testosterone in prostate cancer patients
are similar to strategies that lower estrogens in breast cancer
patients. Sex hormones can accelerate the development of these cancers,
and lowering or blocking them is an effective treatment approach.
Unfortunately, the researchers found that lowering testosterone
levels in men leads to increased weight, increased fat mass, and
decreased muscle mass.

Smith and his colleagues studied forty men with nonmetastatic prostate
cancer. The men received injections of leuprolide depot, a long-acting
gonadotropin releasing hormone agonist, every 12 weeks for one year.
In addition to increased fat body mass, the patients showed increased
serum concentrations of total cholesterol, HDL cholesterol, LDL
cholesterol, and triglycerides. Also, most subjects experienced
anemia, with decreased blood hemoglobin concentrations.

Smith says patients may be able to modify their diet and exercise
in order to offset these adverse effects of androgen deprivation
therapy, but ultimately the long-term solution will be to develop
better drugs for prostate cancer patients. "We need to develop
improved strategies to prevent these side effects," he explains.
"Our research program is evaluating whether other drugs will
have fewer side effects."

Other co-authors of the study are Joel S. Finkelstein, M.D., Francis
J. McGovern, M.D., Anthony L. Zietman, M.D., Mary Anne Fallon, L.P.N,
and David A. Schoenfeld, Ph.D, of MGH, and Philip W. Kantoff, M.D.,
of the Dana Farber Cancer Institute. The study was supported by
the National Institutes of Health, the Doris Duke Charitable Foundation,
and CaP CURE.

Massachusetts General Hospital, established in 1811, is the original
and largest teaching hospital of Harvard Medical School. The MGH
conducts the largest hospital-based research program in the United
States, with an annual research budget of more than $300 million
and major research centers in AIDS, cardiovascular research, cancer,
cutaneous biology, transplantation biology and photomedicine. In
1994, the MGH joined with Brigham and Women's Hospital to form Partners
HealthCare System, an integrated health care delivery system comprising
the two academic medical centers, specialty and community hospitals,
a network of physician groups and nonacute and home health services.